HomeMy WebLinkAboutPROSPECT HEIGHTS #2 BLK 7 LT 6Prospect
D
Heights #2
Block 7
Lot 6
015-134-82
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231390 PID Number: 015-134-82
Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
ERIC & KATHLEEN CAMPBELL
ABSORPTION FIELD - EXISTING
❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
10600 SCHUSS DRIVE, ANCHORAGE
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
5
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
PROSPECT HEIGHTS #2 7 6
Fill added above original grade
Ft.
Gravel length
Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
Ft2
Ft.
Well
100'+
--
25'+
TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
GREER
Capacity
1500 Gal.
Surface water
1001+
--
Material
HDPE
Number of compartments
2
Lot Line
10'+
I --
NA
Foundation
10'+
__
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks Tank installed 5'+ to deck supports.
Alarm location
Electrical installed by
Installer MIKE N ANDERSON, PE (MNA)
PIPE MATERIAL House to tank 3034 Tand a n k to 3034
Drainfield CO/MT
Inspector MNA & FWCS
BENCH MARK (Assumed elevation) 100 ft
Inspection i5' 3/7/2024 2 d 3/$/24
dan3rd
Location and description
4'h
TOP OF MANHOLE
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
h7z��,t�`i
-..-�
AmFAorftQ4•O .
Conditional Approval: Date
' •
TH fill
.. - .....�:*
Septic Syste
,
.. ..............
Approved -
�•_. Curtis Huffman : 0
CE
Date Z 2UL
128991
j;�'lF�•. 4/30/24 .•��G� w
`lSSI�NP
FOPROFESSIO
11l
Note: this approval does not include well permit requirements.
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PID:015-134-82 PERMIT:OSP231390
FIRST WATER CONSULTING
PROSPECT HEIGHTS #2 BLOCK 7, LOT 6
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231390
Work Type: SepticTank Renewal
Tax Code Number: 01513482000
Site Legal Address: PROSPECT HEIGHTS #2 BLK 7 LT 6 G:2540
Site Mailing Address: 10600 SCHUSS DR, Anchorage
Owner: CAMPBELL ERIC & KATHLEEN
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
12/5/2023
12/4/2024
118947
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
AWA/
CO A,i k MoveA_ 21812`(
Rwgwg-ey: T Ssc v-.4 +,:-) Date:
Issued By:Date: / Z�5/Z
5
Development Services Department 1 Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-134-82
Property owner(s) ERIC & KATHLEEN CAMPBELL Day phone 9075295492
Mailing address 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Site address 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Legal description (Sub'd., Block & Lot) PROSPECT HTS. #2 B7, L6
Legal description (Township, Range & Section)
Lot Size 118947 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) 0
(w/wo ADU)
Septic Tank
FX_1
UpgradeL]
Duplex (D) El
Holding Tank
E]
Renewal
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment: it R� 2 O 2l,
r �
Receipt Number:
Permit No. 0 S P Z 3 03 9 0
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
FSrs[ Wder
CONSULTING
SUPPORT E Pldt;:!!F!G
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
February 8, 2024
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: CHANGE ORDER SEPTIC TANK UPGRADE PERMIT OSP231390
LEGAL: PROSPECT HEIGHTS #2, BLOCK 7, LOT 6
PHYSICAL: 10600 SCHUSS DRIVE, ANCHORAGE, AK 99516
The owner has requested that the existing stairs remain with this septic tank upgrade and
therefore this is just a slight change in the previous permitted design. The newer 2000
absorption field was tested in the fall of 2023 with satisfactory results. If elevations for a gravity
septic system cannot be achieved at construction, the 1987 absorption fields will be abandoned in
place. The design will not impact any of the neighboring properties. Please contact us if you
have any questions.
Sincerely,
Curtis Huffman, P.E.
FrstWatI
'f r,a!lsutntla SEfI'lIGES
WATER/W151E'WAIER
SUPPORTMANNINC
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
!
!!
November 8, 2023
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC TANK UPGRADE PERMIT OSP201167
LEGAL: PROSPECT HEIGHTS #2, BLOCK 7, LOT 6
PHYSICAL: 10600 SCHUSS DRIVE, ANCHORAGE, AK 99516
The owner has requested that we renew the OSP201167 septic permit to upgrade the existing
aged steel septic tank on the above referenced lot. There have been no apparent changes to the
lot and adjacent lots that would prevent renewal of this previously issued permit. We propose to
install a 1500-gallon HDPE tank outside any deck supports or install deck support to the bottom
of the tank elevation to serve the existing 5-bedroom residence. If groundwater is encountered
during installation, an epoxy coated steel septic tank may be required.
The 1987 absorption fields will also be located with cleanouts (CO) and monitoring tubes (MT)
installed as required. The lot and area are served by private water with no known encroachments.
The design will not impact any of the neighboring properties. Please contact us if you have any
questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231390, Deb Wockenfuss, 12/05/23
-�
DESIGN CRITERIA:
DECOMMISSION EXISTING SEPTIC TANK & INSTALL NEW 1500—GAL SEPTIC TANK. MAINTAIN
10'+ FROM FOUNDATION, 100' TO PRIVATE WELLS, 5' TO FIELD & DECK SUPPORTS WITH 4'
OF COVER OR INSULATION. CONFIRM EXISTING 1987 FIELD LOCATIONS/ELEVATIONS &
ABANDON IN PLACE IF GRAVITY FLOW CONNECTION WILL NOT WORK TO THE 1987 FIELD.
INSTALL PER AMC 15.65, 15.55, & MASS... TANK BEDDING, SEPARATIONS, MATERIALS,
NO WELLS WITHIN LOT 4
100' OF PROPOSED
SEPTIC TANK
1�
2000
EXISTING
FIELD
LOT 5
/oS�O
DECK
SUPPORTS
(TYPICAL)
MAINTAIN 5'+ TO
EXISTING SUPPORTS 1
FOR DECK & FIELDS °
AS SHOWN. \
RECONNECT MH
TO EXISTING
FIELDS \ ^^O0 > -
U1 v
VERIFY & MAINTAIN �7
5' TO EXISTING FIELDS. ��
IF GRAVITY FLOW
CANNOT BE MAINTAINED
TO 1987 FIELDS, ABANDON
FIELDS IN PLACE.
01V'" i
=Arm
PUMP EXISTING SEPTIC
1� J 5BR
TANK / ADD CONCRETE —
2.0' RESIDENCE
2� �
O
S.T. & INSTALL NEW
1 7'
�
NO FOUNDATION
EDGE OF DECK ,
1
WITH NEW DCO &
ON GRADE
W/ TREATED `r3 11
___V�2.
WOOD
=Arm
PUMP EXISTING SEPTIC
SUPPORT®SERVICES:
TANK / ADD CONCRETE —
DECOMMISSION EXISTING
100' WELL
S.T. & INSTALL NEW
RADIUS
1500—GAL SEPTIC TANK
MUST BE
WITH NEW DCO &
STAKED
DIVERTER.
PRIOR TO
CONST.
IF 1987 EXISTING
FIELD IS CONNECTED, LOCATE:
ADD COs AT ENDS NEAR
INSTALL PROPOSED NEW TANK
MT AS— & END OF 2ND
NEEDED TRENCH, INSTALL OR
VERIFY MTs ARE INSTALLED
IN EACH TRENCH. OTHERWISE
ABANDON IN PLACE FOR
FUTURE CONSIDERATION / USE.
CO
ASSUMED END
OF 65' LONG
TRENCH
^ PER MOA DOCS
k`" APPROX 100'
WELL RADIUS
STAKE PRIOR
TO CONST.
PROSPECT HEIGHTS #2 BLOCK 7, LOT 6
SUPPORT®SERVICES:
PREPARED FOR:
ERIC & KATHY CAMPBELL
10600 SCHUSS DRIVE
ANCHORAGE, AK 99507
C
FIRST WATER CONSULTING
DATE: 02/08/2024
13030 SUES WAY
SURVEY: KGL
DRAWN: FWCS
ANCHORAGE, AK 99516
SCALE: 1" = 30'
907-350-9566 FirstWaterAK@gmail.com
DRIVE
NO WELLS WITHIN
100' OF PROPOSED
SEPTIC TANK
®®®®®
OF AL'j 11111k �
9TH* *�
't rtis Huffman
r� CE 128991
IN
02/08/24 ®®
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 . 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP201167
Work Type: SepticTank Upgrade
Tax Code Number: 01513482000
Site Legal Address: PROSPECT HEIGHTS #2 BLK 7 LT 6 G:2540
Site Mailing Address: 10600 SCHUSS DR, Anchorage
Owner: CAMPBELL ERIC & KATHLEEN
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
t»ent Is,
o�
ri v
Department
7/6/2020
7/6/2021
118947
❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By:
Issued By:
Date:
Date:
5
j;
MUNICIPALITY OF ANCHORAGE
Development Services Department % Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-134-82
Property owner(s) ERIC & KATHLEEN CAMPBELL Day phone 9075295492
RAnilinn nririragc 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Site address 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Legal description (Sub'd., Block & Lot) PROSPECT HTS. #2 B7, L6
Legal description (Township, Range & Section)
Lot Size 118947 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
(® all that apply)
Absorption Field
❑
Initial ❑
Septic Tank
0
Upgrade 0
Holding Tank
❑
Renewal ❑
Privy
❑
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
TYPE OF DWELLING:
Single Family (SF) El
j- (w/wo ADU)
Duplex (D) ❑
Multiple Dwellings ❑
(SF and/or D)
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment: to� Gt 212-0
Receipt Number: - Wi `[ 3
Permit No. -- 6 6 p9�6 I I (off"
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water an"UterVrms\Client FormsTermit Application.doc
259'x. DISCOUNT APPLIED
The location of }he tr,Irtl;rRlg18',
shown on this iecorti
as -built) complies wnn ,lie - l
By: e
LI -Z,1112
Date: Z- 12 61/3
1
I
1
LOT 4 \
O
O.
y
Y : 1s GRASS EDGE
RETAINING WALL /
V / .
ti Q
PLOT PLAN AS BUILT X SCALE 1" = 50' GRID 2540 Project No. 12-088/A1
Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
907) 522-6476 PhoneRegisteredLandSurveyors (907) 522-4625 Fax ,poo op0ken®longsurvey.com / jonothen®langsurvey.com OF A
I hereby certify that I have surveyed the following described property: OSP • • • • • • • • ;9s Q
LOT 6, Block 7, Prospect Heights Subdivision #2 ( Plat 76-158) ••• •'OQAnchorageRecordingDistrict, Alaska, and that the improvements situated thereon are 49TH
within the property lines and do not encroach onto theproperty• ' • •' ......... ••• • ........... adjacent thereto, thatnoimprovementsonthepropertylyingadjacenttheretoencroachonthesurveyed Q _ 0premisesandthattherearenoroadways, transmission lines or other visible
easements on said property except as Indicated hereon. QO c•' KENNETH G. *•*
Dated this the Stf Day of 'rte ,. Q LS -5202 GG
Za_2, , at Anchorage, Alaska 04'•.,`-y'-L •'p
It is the responsibility of the owner to determine the existence of any easements,SSIONAL " covenants, or restrictions which do not appear on the recorded subdivision plat. DOppppo a
7/7/2020
1
MUNICIPALITY OF ANCHORAGE
Development Services
Departmentj Phone: 907-343-7904
On -Site Water & Wastewater Section "' Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-134-82
Property owner(s) ERIC & KATHLEEN CAMPBELL Day phone 9075295492
Mailina address 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Site address 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Legal description (Sub'd., Block & Lot) PROSPECT HTS. #2 B7, L6
Legal description (Township, Range & Section)
Lot Size 118947 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
all that apply)
Absorption Field Initial Single Family (SF) 0
i (w/wo ADU)
Septic Tank Z Upgrade 0
Duplex (D)
Holding Tank Renewal
Multiple Dwellings
Privy SF and/or D)
Private Well
Water Storage
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Signature of property owner or authorized agent)
Permit/Rush Fees: 0126' 14'a -+5 Waiver Fees:
Date of Payment: to GL povi --b Date of Payment:
Receipt Number: _6 0 `[ Z Receipt Number:
Permit No. 13 6p -'Z6 I I (o-" Waiver No.
t'
GADevelopment Services\Building Safety\On Site Water an&s ttWrms\Client Forms\Permit Application.doc
259. DISCOUNT APPLIED
13030 Sues Way, Anchorage, AK 99516
907-350 -9566 / firstwaterAK@gmail.com
June11, 2020
Municipalitiesof Anchorage
On-SiteWater & WastewaterProgram
4700 ElmoreRoad
Anchorage, AK99507
RE: SEPTIC TANKUPGRADEPERMIT
LEGAL: PROSPECTHEIGHTS #2 BLOCK 7, LOT 6
The ownerhas requested thatwe obtaina septicpermitto upgradethe existingaged steelseptic
tankon the above referencedlot. We proposeto installa 1500-gallonHDPE tankto serve the
existing5-bedroomresidence. The lot andareaareservedby privatewater. The designwill not
impactany of theneighboringproperties. Pleasecontactus ifyou haveanyquestions.
Sincerely,
CurtisHuffman, P.E.
MunicipalityofAnchorage
On-siteWaterandWastewater
REVIEWEDFORCODECOMPLIANCE
OSP201167, RebeccaCarroll, 07/06/20
FIRST WATERCONSULTING
PROSPECTHEIGHTS #2 BLOCK7, LOT 6
MunicipalityofAnchorage
On-siteWaterandWastewater
REVIEWEDFORCODECOMPLIANCE
OSP201167, RebeccaCarroll, 07/06/20
Municipality of Anchorage Page of —3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL'SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: 5Idi 000 Liy 3 PIE)Number: s2/ 5 — f 3 y — 8 2
Name. Wastewater System: New Upgrade
VI
Address: ABSORPTION FIELD
Oo sc v DL +
Phone: No. of Bedrooms: eep Trench O Shallow Trench O sed O Mound Other
S°"""'"9' r,
pride
Total Depth from origin grade
LEGAL DESCRIPTION P F
Lot: Block: Subdivision:. 0•pth to pipe bottom from original grade: Gravel depth beneath pipe
7
Mb`s F Ft
TownMID; Range: Section: FIII added above original grade: Gravel length:
k, 0 FtFt.
Gravel width: Number of lines: O.dance benvW Imes
WELL: New Upgrade Ft. I--- Ft
Classification (Prwats. A.13i Total Depth: I
Cased To: Total absorption ares Pipe matin I: _
ft. Ft. V10 50 Ft''
Driller: Date Drilled: Static water L": InstallerDate Installed' Iv 4-P'16 -ZaoO
Fl.
Yield: Pump Sel at: citing Height Above Gram": TANK
GPM FI. FI.
SEPARATION DISTANCES aseptic 0Holding OS.T.E.P.
TO 111,00c Absor0llon un Holding blic/Pnvele Manufacturer. 1r1 capacity In gallons:
From Tank Field slallon Tank sewer Linea
MateA91: Number o/ Compartments:
I YVwelrtI0ICO
surface(
tato N LIFT STAT)ON
Water o
Lot
v
Sin In gallons:Manufacturer.
Line i
Pump on" level a4' "Pu off" level at: Nigh water alarm It:
Foundation J
Pump Make a Model ctnoal Inspectlons performed by:
Curtain
Drain
BENCH MARK
Remarks:
Location and Description: ,1
IJ I=0 Aasumed Elevation: !" i Ie.
ENGINEERS SEAL
TI I
3fO
Inspections performed by: ! S Dates:ls
iD Q•S 002nd r....h,
Department of Health and Human Services approval adz'. •,.: = '
Date: Reviewed and approved by:
f7-013fAev 9190 MOATS
h
1> B
C F
i
SWIG AFS:
O or 43FT
AC B7
BC 815
AD 112
BD 128
D STANDARD S -BEDROOM SEPTIC SYSTEM
LANK 1500 GAL
STANDARD DEEP TRENCH
TOTAL LENGHT 60 FT
TOTAL DEPTH 11 FT
CFFECT7VC ROCK 7 ET
COVER 4 FT
D(VERSON VALVE
CHECKCHECK INIEGRYTY Of EXISTING TANK
E. •...........
11
1x•11
i......
SxS'.%5:...
TO •EN•SPURKlANO j •
CE -2225
11'•.x._
lh tSS1•`
Well
SCALE: i' = 50 Fr.
125
BENCH MARK. BOTTOM SZOING
rOBBEN SPURXLANO P.E. PROSPECT HEIGHTS BLOCK 7 LOT 6 11
SEPTIC SYSTEM AS BUILT
203 W 15TH. AVENUEDATE: OCT. 30, 2000
ANCH. AK. 99501 JERRY X/NN
10600 SCHUSS DRIVE SHEET,• 2/3 GRID: 1540
PERMIT 1 SV000443 PID N 015-134-82 PR007062.DVG
Standard Trench:
N17 SCALE
Sit t Ba
8J.0 L^
7.0 rt of Septic Rock
Effective
2' Vide
60' Long
11' Deep
7.0' Sewer rock
4' Cover
FLOW SPLITTER
Monitor
Cleanout
NO SCALE U 77 0
V U_ O
w
1500 gal Septic tank o
TO ORIGINAL TRENCHES 0a
V
e0
a
c3
49th
No. CE -2225
1500 got septic tank
TUBBLN SPURKLAND P.L. PROSPECT HEIGHTS BLOCK 7 LOT 6I I
SEPTIC SYSTEM SCHEMATIC
203 W15th AveDATE- OCT. 30, 1000
Anchorage Ak 99501
JERRY KINN
n
9 10600 SCHUSS DR/Vf SHEET. 3/3 GRID 2$40
PERMIT j SPI000443 PARCEL ID I 015-134-82 PR007063.DWG
Permit Number: SW000443
MUNICIPALITY OFANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
907) 3434744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Legal Description: PROSPECT HEIGHTS #2 BLK 7 LT 6
io/ail/ov
Date Issued: Oct 19, 2000
Expiration Date: Oct 19, 2001
Parcel ID: 015-134-82
Design Engineer: 0007 Tobben Spurkland, PE Site Address: 010600 SCHUSS DR
Owner Name: Jerry Kinn Lot Size: 118947 SQ. FT.
Owner Address: 10600 Schuss Dr. Total Bedrooms: 5 Permit Bedrooms: 5
Anchorage , AK 99516 -
This permit is for the construction of.
O Disposal Field M Septic Tank Holding Tank M Privy Private Well E] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
If– Date: 4Q—2Y—t<L"
Issued By: / < \
Date:
Ti'.SP SLAM P.E.
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
907) 279-3916
Fax (907)-276-6013
SEPTIC SYSTEM UPGRADE DESIGN
LOT 6 BLOCK 7 PROSPECT HEIGHTS #2 S/D
JERRY KINN
Municipality of Anchorage October 3, 2000
Department of Health and Social Services
825 L Street
Anchorage, Alaska 99501
We are submitting an application for the upgrade of the septic system for this lot. The submittal
consists of three (3) drawings showing the present improvements on the lot and the adjoining
properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is
subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil
logs and percolation tests of applicable testholes are also enclosed. The septic system design is
based on the following:
No Ground Water or Impervious Layer to 19 ft.
Use Standard Trench
Soil Rating. From Testhole 10/02/00
5.3 min/in = 1.2 gal per sq.li/day
No. of Bedrooms 5
Required Area per Bedroom: 150/ 1.2 = 125 sq.ft.
Total area required: 125 x 5 - 625 sgft
Testhole depth 19 feet
Bottom Rock At 11 feet
Top Rock At 4 feet
Rock Depth 7 feet
Total Trench Length 625 / 14 = 45 ft.
USE 60 LF
SYSTEM CONFIGURATION
STANDARD TRENCH
TOTAL LENGTFI 60
TOTAL WIDTH 2
TOTAL DEPTH 1 I
ROCK DEPTH 7
COVER 4
SEPTIC TANK 1500
FT
FT
FT
FT
FT
GAL Check integrity of existing tank
The installation of this septic system will not prevent development of adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
to
i
lot
lot 5
i
lot 5
50 0 50 100 150 200 250 300
SCAL-5. 1' 10 FT
i
lot 3
t 7
i i
lot 6
I1
JSS
S
lot 4
SILIMIk
g
K
G OF
DIN SPURKLAND
No. EE -2225
PROFESS
rOBBEN SPURKLANO P.E. PROSPECT HEIGHTS BLOCK 7 LOT E 11
SEPTIC SYSTEM DESIGN
I203W15TH. AVENUEDATE.• OCT. 4, 2000
ANCH. AK. 99501
JERRY KINN
10600 SCHUSS DRIVE SHEET, 1/3 GRID: 2540
PERMIT N SW000XXX PID N 015 -174 -RP PR007061.D WG
f?
well
S)PERCO TI TEST
STANDARD 5 -BEDROOM SEPTIC SYSTEM
TANK 1500 CAL
STANDARD DEEP TRENCH /
TOTAL LCNGHT 60 FT
TOTAL DEPTH I/ FT
EFFECTIVE ROCK 7 T
COVER /
DIVERSION VALVE
CHECK INTEGRITY Of EXISTING TANK
49th
i................................e. \ /
TOB N SPURKLAND
No. EE -2225
P PROF ..........
25 0 2 50 75 100 125 150
SCALE.- 1' = 50 FT
TOBBEN SPURKLAND P.E. PROSPECT HEIGHTS BLOCK 7 LOT 6 SEPTIC SYSTEM DESIGN
203 P1 151H. AVENUEDATE: OCT. 4, 2000
CM. A 99501 1060ANK_
JERRY KINN
0 SCHUSS DRIVE SHEET: 2/3 GRID: 2540
I PERMIT # S W000XXX PID # 015-174-R? PR007062.DWG
SN t
7,0 ft of
Effective
v v p
1500 gal Septrc tank o
caa
Standard Trench:
c0
2' W(dP a
60' Long o
11' Deep L`
7.0' Sewer rock
4' Cover
sem
i ir'ri wt L
NO SCALE
49th V,
1s -N SPURKLAND
No. CE -2225
NU JLHLG
TUBBLN SPURKLANDP.L. PROSPECT HEIGHTS BLOCK 7 LOT 6 I I
SEPTIC SYSTEM SCHEMATIC
203 W15th Ave DATE: OCT. 04, 1000
Anchorage Ak 99501
10600E
SCHUSSDRIVESHEET, 313 GRID: 2540
PERMIT I SY/OOOOXX PARCEL ID X 015-134-81 PR007063.DWG
0
PERFORMED
LEGAL
1
2
3
4
Munlclpallty of Anchorage
DEPARTMENT OF •iEALTH & HUMAN SERVICES
825 "L" Street, Alu:horage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
Prc-eyl-ea 0-1.114
S;/ f-
SLOPE
ENGINEERS SEAL)1, tr
J
C- ....,
s J
DATE PERFORMED:
Section:
SITE PLAN
WAS GROUND WATER I DENCOUNTERED)
SJ.
IF YES. AT WHAT LO V
DEPTH? PE
Depth to water All IG
Monitoring) ' Oate: g yr
20 PERCOLATION RATE SL -13 (mmulevinch) PERC HOLE DIAMETER
TEST RUN BETWEEN —5 FT AND & FT
DISCLAIMER- frnundwatPr conditions indicated are for the dates shown only.
Past and future presence and/or depth of groundwater can not be predicted
romese o f rva t n .
PERFORMED BY: /• S 1 ('
S CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIC ELINES IN EFFECT ON THIS DATE. DATE:
72-009 (Rev. 4/85(
5
6-
7
n
8
i.
9
1 O
11 t
12
13
f f'
414-
1515. r
616-
1717
18
G3aTi ou-r o r
19
SLOPE
ENGINEERS SEAL)1, tr
J
C- ....,
s J
DATE PERFORMED:
Section:
SITE PLAN
WAS GROUND WATER I DENCOUNTERED)
SJ.
IF YES. AT WHAT LO V
DEPTH? PE
Depth to water All IG
Monitoring) ' Oate: g yr
20 PERCOLATION RATE SL -13 (mmulevinch) PERC HOLE DIAMETER
TEST RUN BETWEEN —5 FT AND & FT
DISCLAIMER- frnundwatPr conditions indicated are for the dates shown only.
Past and future presence and/or depth of groundwater can not be predicted
romese o f rva t n .
PERFORMED BY: /• S 1 ('
S CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIC ELINES IN EFFECT ON THIS DATE. DATE:
72-009 (Rev. 4/85(
MUNICIPALITY OF ANCHORAGE
D. ~:RTMENT OF HEALTH AND HUMAN SEF ;ES ?j
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 O
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
ISE i //S rstiDv,
DISTANCES
Address TO SEPTIC ABSORPTION
7o Z 1 iU/FTyc%ooD
FROM TANK FIELD WELL
WELL I Z -7 r j
I3(o
Phone(s)
3 x&9
Permit No. No. of Bedrooms
70Zgb/ y S b'p
LOT LINE
7-Z{ 5_5 7
aLEGALDESCRIPTION
Lot Block Subdivision
Crlc/,§/fi> Fz FOUNDATION
Township, Range, Section
v56(. `%J%L( 13 701 V .(-/ S/i/ _ / Z{U % N(? F_ v ZtJ AS-BUILT DIAGRAM (Show location of well, septic system, property hoes, foundation,
driveway, water bodies, etc.)
TANKS
SEPTIC HOLDING
Manufacturer Capacity in gallons
AIC 6RAKE: 1 /Ln1 600
Material No. of Compartments
EL 7-Id 6
TYPE OF SYSTEM
TRENCH RED W. DRAIN OTHER
Depth to pipe bottom from Total depth from original grade 1W LL
original grade
7 FT FT
D
Fill added above original grade Gravel depth beneath pipe
FT 2- FT aGravellengthGravelwidth
C, 30 FT J FT
Total absorption area 4- Z9 'yyl Distance between lines
SO FT O FT
qqVNumberoffinesSoilratingAIematerial
2 Sp FT PVC- -6 30-5 4 IL Sr 1)810&1
r` Installer Date Installed
WELLS
X PRIVATE OTHER (Identify)
T
I
B
Er
S d iV,- f
Classification (A,B,C) Total Depth Cased to
FT FT
Installer Dale Installed:
REMARKS:
W ELL i V:5 r/4 LL 9-,b iti 12 %EY/ovs
l 0 N VA C to lu T Lor
Scale: it _ ypr
gj
Inspections Performed by:
II AlE /Vlcl%4.r l,cls fia`a
ooesme.,,;
a
Date: eo°° _¢ yj(y nap °7 9A
p y p-)/.°O(J at.]
aor
v(/9/pdun0/p/3/f).:»
JesCne
a
dee ea e
was performed according to all f•, v -.'`. Michael E. Anderson s
joaMMNoaoe
r //JD fll f certify that (his inspection
Municipal and State guidelines in effect on s3lpte:
r- LLc@0 '
uGA
f> p » ala q 0 .
G QHealthDepartmentApproval: ! L-/ • Date: / / •'
MUNlClPALllY OF ANCHORAG
Department o Health & Human Services
825 L Street, Anchorage, Alaska 9 501 343-472
DN~SITE SEWER PERMIT
Permit Number: 8702B0
Uate Issued: 10/19/87
Owner Name: DESIGNS IN WOOD LTD Day Phone: Ownor Address: 7O21 DRIFTWOOD 349~8014
ANCHORAGE AK 99518
Parcel Id: 15-134-82
Lot Lega1^ Subdi i iCalvson: [pMU PECTHEIGHTS#2 Lot:6. BIock: 7/
Section: 13 ToISshiP: 1211 Range: '3W '
Lot Size 87000 (sq.t" or acres)
ax Bedrooms: This Permit: 5 lotal Capaciiy: 5
SEWER SYS lEMS: Listed below a,e the options available to you in designing yoursewersystem. Choo e ihe option that best [its your site.
Depth Lo Pipe Boitom (ft): 6.5 6.O
Grave1 Depth (ft): 0.5 1.0
Total DepLh (ft): 7.0 7,0
Gravel Width ({t): 24.0 5.0
Gravel Length (ft): 47.0 132,O **
Gravel Volume (cubic yds>: 41,8 36.7
oil Rating Used (sq ft/brm>: 150 150
Gravel length > 50 {eet rVO4uires muliipicy soils tests,
Gravel length > 75 feet requires multiPle runs (not exceeding 75 ft each)`
LlFT STATlON: }f to liIt station is installed, a high water alarm must be
connected to the residence.
SEPTIC TANK: Minimum total septic tank capacity: 1,500 gallons Each septictankmusthaveatleast2compartments. Depth to top o septi` tank(s) < 4 0
eeL requires insulation over tank(s). ` ^
INFORM D,H.H"S. BEFORE 1111 & NY-, 11INSPECTIONS BY ENGINEER
October 5, 1987
Municipality of Anchorage
Environmental Engineering Div.
825 L St.
Anchorage, Alaska
99501
Re: OnSite Septic System - Lot 6, Block 7 Prospect Heights -*12
Gentlemen,
Please find the data enclosed for design of an onsite septic System for the
subject property. If you have any questions please contact me at 276-3770.
Yours Truly,
lqv"L (:
Michael E. Anderson, P.E.
4 SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
El PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: l/ /'I/OO.P DATE PERFORMED: 9' 30-87
LEGAL DESCRIPTION: LOT L /DS GT 117- '*z'
DEPTH
SLOPE SITE PLAN
FEET)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
V/svAL/y R/+7-4®
l c/ELG
G
V -i1 o r„
oti cos eacea u oe 000%WJB o_e_a c e e'n•B''se
N M!chocl E. 6,ndars on s+ il.
4381 - E
Fop,
WAS GROUND WATERS S
VENCOUNTERED? L
O
P
IF YES, AT WHAT
E /'
DEPTH?
Reading Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch)
u
TEST RUN BETWEEN FT AND FT
COMMENTS SO/Ls.Fi s`rnlEErt/ 6-1Z' V/.S UA//ye/7TFD-/1T /SO [Q FT/9.0R
PERFORMED BY: 1i %fV111F ///4/,E11J CERTIFIEDBY:1ii,(t tiL1 {Iw'IIATE: Is
JOB o r -., 7 eCO--S r,7- 11-7-3
SHEET NO. // OF
CALCULATED BY l RClc1P7Le DATE
CHECKED BY DATE
SCALE
IL
oot
Mt+i Professional Service Industries, Inc. 700 W. 58th Avenuerv
Pittsburgh Testing Laboratory Division Anchorage,/-o askasss,e-,ssz
n \1\O "
REPORT OF: y, Passing #10
PROJECT: Prospect Heights
CLIENT: Montgomery Engineers
SAMPLED BY: Client
SAMPLE DATE: Unknown
DATE TESTED: 10/14/87
REPORTED TO: 2- Client
SAMPLE DESCRIPTION/LOCATION
Dirt
LABORATORY NO.: 1814
ORDER NO.: ANC 900
DATE: 10/15/87
Respectfully submitted,
e
Brian H. Barron,
District Manager
All PEPO TS A SU YED AS TME CONE NrY PROPEFI Of r. ENTS. PU CATON OF STATEMENTS. OONCLUBgNB O 9........ . .
Tl
Municipa tty
of
Anchorage
August 25, 1987
P.O. 6 X 196650
ANCHORAGE, ALASKA 99519-6650
907)264-4111
TONY KNOWLES,
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
Tamara Sanderson
Acreage Systems, Inc.
Suite 165
Anchorage, Alaska 99503
Subject: Well Approval, Lot 6 Block 7 Prospect Heights_
Dear Ms. Sanderson:
I have reviewed the well flow test and coliform sampling
results for the subject well. The information submitted to
this office indicates that the well meets flow requirements
specified by the municipality and is free from coliform
contamination at the present time.
It should be noted that the observations above should be.in no
way construed as a Health Authority Approval of the subject
well. The well has not been inspected by a registered civil
engineer as is required in the Health Authority Approval
process.The department has no information about the location
of the well on the lot in relation to adjacent septic systems
or whether the well has been constructed in compliance with
code requirements. Information on nitrate levels in the well
has not been submitted to this department. Furthermore, there
is no approved wastewater disposal system on the lot.
Sincerely,
Stephen S. Morris
Civil Engineer
n -site Services
JOE GIELAROWSKI
DRILLING CO.
MILE 501/2 PARKS HWY LIFETIME ALASKAN SERVING ALASKA
892-7950 P.O. BOX 772847, EAGLE RIVER, ALASKA 99577
OWNEROF LAND....................................................................................... DEPTH OF WELL.................................................................................
ADDRESS......................................................................................................
WELL- SITE...............................................................................................
DATE- STARTED......................................................................................
DATE- ENDED...........................................................................................
KIND OF FORMATION:
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT.....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
FROM......................
FT. TO ......................
FT....................................
MISCL. INFORMATION:
STATIC LEVEL OF WATER FT ..........................................................
DRAWDOWN FT.................................................................................
GALS. PER HR.....................................................................................
KINDOF CASING.......................................................................... ......
FROM....................... FT. TO ....................... FT.............................
FROM ....................... FT. TO ........................ FT............................
FROM....................... FT. TO ........................ FT............................
FROM....................... FT. TO ........................ FT............................
FROM FAVICIPAL11Y OF AN%ORAGE
6E1ii b� �I�AL'tN & ..........................
FROM FT.-1 pIRONMENTAL PRo IFTION
....................... ........... ....................
FROM....................... FT. TO .... D C..2-0—M5........................
FROM ....................... FT. TO R c— L I VE V..............
FROM....................... FT. TO ........................ FT.....................
FROM....................... FT. TO ........................ FT......................
FROM....................... FT. TO ....................... FT........................
FROM....................... FT. TO ........................ FT.......................
-/ (,()J
?S b
DRILLER'S NAME.............................................................................................................I
7,7
1 /.
2
P.O. SOX 6610
ANCHORAGE. ALASKA 99502-0650
907'264-4111
ONYi04'0 V,1LFS,
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 10, 1986
TO: Permit Applicant
Subject: Permit # 850608
Lot 6 Block 7 Prospect Heights Subdivision #2
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
Permits are issued on a calendar year basis by authority of MunicipalOrdinance. A new permit must be obtained from this Department for any
well and/or on-site sewer system not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as -built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/ljw
enc: Copy of Permit
I certi y that:
1. I am familiar with the requirements for on-site sewers and as set `
lhorth by the Municipality of Anchorage (MOA) and the State of Alaska,
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3" I will adhere to all MOA and State for the set back
distances from any, existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot."
4. I understand that this permit is valid for a maximum of' 4 bedrooms and
any enlargement will require an additional permit"
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE '
ELECTRI AL WORK MUSTBE DONE BY A LICENSED ELECTRICIAN. `
SIGNED ^ DATE 51_
APPLICANT: WILLIAM ARMSTRONG ^
ISSUED BY TE:
c--
u
1: Mum— 1. wm IWIFT,
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET ANCHORAGE, AK 99501 `
264-4720
1:1 IVU --- W 1 -1 " EE PLIP-11 IFR ;9" .... F F! Poo 1-
PERMIT NO: 850608
DATE ISSUED: 09/20/85
Z-1 "tz°4'*^ cof zrf" to" IS e.
APPLICANT: WILLIAM ARMSTRONG e,
ADDRESS: 14701 PRATO R ST"
ANCHORAGEq AK 99516
CONTACT PHONE: 276~8057
LEGAL DESCRIP: SUBDIVISION: PROSP CT HEIGHTS 2 LOT: 6 7
SECTION: 13 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 118500 (SQ"FT^ OR ACRES)
MAX BEDROOMS: 4
Listed below are the available to you in designing your septic
system. Choose the option that best fits your site"
FIZ HA 1=1 IE1:: 13 MOVII e-:,%][IIM"
DEPTH TO PIPE BOTTOM (FT") 4'0 4"O 4"0
GRAVEL DEPTH (FT.) 3.5 0"5 3^0
TOTAL DEPTH (FT") 7,5 4.5 7"0
GRAVEL WIDTH (FT. > 2.5 28.O 5"0
GRAVEL LENGTH (FT"> 164.0 ** 54.0 134"0 **
GRAVEL VOLUME (CU,YDS.) 60^8 56.0 86.9
TANK SIZE (GALS) 1,250"O it I. 1 250,0 *d 1,250^O
SOIL RATING (SQ"FIT. MR) 287 250 287
GRAVEL LENGTH > 75 FT" REQUIRES MULTIPL RUNS (NOT EXCEEDING 75 FT" EACH>
TANK,MUGT HAVE AT LEAST TWO COMPARTMENTS
I certi y that:
1. I am familiar with the requirements for on-site sewers and as set `
lhorth by the Municipality of Anchorage (MOA) and the State of Alaska,
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3" I will adhere to all MOA and State for the set back
distances from any, existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot."
4. I understand that this permit is valid for a maximum of' 4 bedrooms and
any enlargement will require an additional permit"
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE '
ELECTRI AL WORK MUSTBE DONE BY A LICENSED ELECTRICIAN. `
SIGNED ^ DATE 51_
APPLICANT: WILLIAM ARMSTRONG ^
ISSUED BY TE:
I SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
825 L. Street, Anchorage, Alaska 99507 264.4720
TEST
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: h -L"" 9rrr1 s><rona DATE PERFORMED:fzIV
LEGAL DESCRIPTION:. Lal f%/gh/s 6er6dvis/a/-7
DEPTH SLOPE SITE PLAN
I `irgclrJi /V/at
1 s, /
y.
Sa ci'-4 wc
2 .//{crna ir
9r.
n yrczve /
TO Goa rSe 9'e
3-
4-14
5
6
7
8
a I C/ay y vrave/ (GC)
g /70/5/ fa 6YGf
ly
rnois f
11 WAS GROUND WATERS/
ro LENCOUNTERED?
12 P
IF YES, AT WHAT E
13 8/Z /g4
DEPTH?
14
15
16
17
ues ts(+yD 'M Prby tC t u
18
o e: •.fo eee°ewps°w oeo. C
aal 19
Nof to Sccr/e
Reading Date Gross
Time
Net
Time(,77/17•)
Depth to
Water/17d
Net
Drop
8 2 84 2;36-,0,17 2v 35,25 0
2 2:50 3S 36,00
NONE
3 3 : o 5 50 36. 5v a. so
4 3; 20 6 5 37, o0
5 3;35 go 37.50
Nof to Sccr/e
Reading Date Gross
Time
Net
Time(,77/17•)
Depth to
Water/17d
Net
Drop
8 2 84 2;36-,0,17 2v 35,25 0
2 2:50 3S 36,00 0.76
3 3 : o 5 50 36. 5v a. so
4 3; 20 6 5 37, o0
5 3;35 go 37.50
PERCOLATION RATE Jho (minutes/inch)
TEST RUN BETWEEN 3' FT AND 3.5 FT
COMMENTS % , r Or'l77B O/ On rG/d%/V//Qcz
11—.T.S/hZsl 76 u 17 trr o
G'cx.57 i r7 CT r c, r771e r' F b><
PERFORMEDBY:rGc> G / CERTIFIED BY:/E—. Y: c—. , Cdttea%.... DATE: S,Izlg4
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
0 L'
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax. 907-343-7997
Parcel I.D. 015-134-82
Certificate of On -Site Systems Approval
3/1L
��25
Expiration Date: , _ ;
Legal description PROSPECT HEIGHTS #2 BLK 7 LT 6
Site address 10600 SCHUSS DR Anchorage AK
Current property owner(s) ERIC & KATHLEEN CAMPBELL
X The On-site system(s) is/are approved for 5 bedrooms
Conditional approval for
Comments or advisories:
E
bedrooms, with the following stipulations:
Original Certificate Date: 5/29/2024
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA ApprovaLJune 2022
AUNICIPALITY OF ANCHORAGF.-
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-134-82
Complete legal description PROSPECT HEIGHTS #2 BLOCK 7, LOT 6
Location (site address) 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Current property owner(s) ERIC & KATHLEELN CAMPBELL
2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: F* Private Well serving # 1 dwelling units
0 Other Non-public well as regulated by MOA [:] Water Storage
F-1 Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: [X Private Septic E] Private Septic serving 2 dwelling units
0 Holding Tank F] Community Septic or Public Sewer
5. SEPTIC TANK: F] Steel [W Plastic F -I Concrete F-1 Fiberglass
Age 1 - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: n AWWTS n Bed X Deep Trench F] Wide Trench n Seepage Pit
Waiver request for:
Expedited review requested: F-1
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $
Date of Payment
COSA #
Waiver Fee $
Date of Payment
Waiver #
COSA Application—Apr2025,doc
COSA Checklist
Legal Description: PROSPECT HEIGHTS #2 BLOCK 7 LOT 6 Parcel ID: 015-134-82
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 9/25/1985 Total depth 220 ft
Cased to 40+ ft (ASSUMED / NOT LEGIBLE)
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 11/02/2023
Static water level at beginning of test 79 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank NA
Date of pumping *NA — NEW TANK
❑ Required maintenance completed, if AWWTS
Comments: *This house has not been lived in.
D. ABSORPTION FIELD DATA
Which system tested (date installed) 10/24/2000
® ALL standpipes present per record drawing
Total measured depth from grade 11.8 ft (max)
Measured depth to pipe invert from grade 4_7 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
® Monitor tubes (MT) go to bottom of effective. (ED)
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Well production at time of test 3_9 gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is. Negative
Nitrate 1.56 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by NES Date 4/30/2025
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 11/02/2023
Results ID Pass
Fluid depth prior to test 12 in
Water added 750 gal
New fluid depth 19 in
Elapsed time 1440 min
Final fluid depth 10 in
Absorption rate 750 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 84 in (MOA r ED)
Effective depth used 10 in (Final Fluid Depth)
Effective depth (ED) remaining 74 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots &
appears approximate.
COSA Checklist copy.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No ft
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100'
® Yes if No ft
Tank to Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Field to Property Line > 10'
® Yes
if No
ft
Private Wells > 100'
® Yes if No ft
Water Main > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350.9566
Engineer's Printed Name CURTIS HUFFMAN PE Date 05/08/2025
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,AW �'�`. • ' • • ' • . •�
local soil characteristics, groundwater levels that may fluctuate during the year, quality of .�'��` • .� }
construction (workmanship & materials), the water usage of the family being served by the "oe
system and maintenance. The operational life of all well and septic systems are subject to TM
these various and dynamic characteristics and are outside the control of the evaluator of the .... .... .........
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or • , • • ,t
discrepancies exist can be given by First water Consulting & FWt S ' • ' a • CUItIS Huffman
�'�"a•s CE 128991
�'srF• . 05/08/25 . •�,�?��
COSA Checklist copy.docx
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I. D. 015-134-82
Certificate of On -Site Systems Approval
Expiration Date: 3/18/2025
Legal description PROSPECT HEIGHTS #2 BLK 7 LT 6
Site address 10600 SCHUSS DR Anchorage AK
Current property owner(s) ERIC & KATHLEEN CAMPBELL
X The On -site system(s) is/are approved for 5 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 5/29/2024
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval June 2022
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-134-82
Complete legal description PROSPECT HEIGHTS #2 BLOCK 7, LOT 6
Location (site address) 10600 SCHUSS DRIVE, ANCHORAGE, AK 99507
Current property owner(s) ERIC & KATHLEEN CAMPBELL Day phone
2. ON -SITE SYSTEMS SIZED FOR 5 BEDROOMS
3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass
Age _NEW - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
istance:
By applying for this entitlement, this property is subject to inspection by municipal On -site staff
to verify the accuracy of the information provided.
COSA Fee $ Waiver Fee $
Date of Payment 3,z71-e- Date of Payment
COSA # 0 S C Z `% / ID� Z. Waiver #
COSA Application.doc
Parcel I. D. 015-134-82
Municipality of Anchorage
On -Site Water and Wastewater Program
907) 343-7904
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description
Expiration Date: 4 - 9 - I
PROSPECT HEIGHTS #2 BLOCK 7 LOT 6
Location (site address) 10600 SCHUSS DR., ANCHORAGE, AK 99516
Current Property owner(s) GEORGE HAUGEN
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
Duplex
Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
5
Day phone 563-6571
Day phone
v
DEC 1 9 /013
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well r5fl Individual
Individual Water Storage Holding Tank
Community Class Well Community
Public Water System Public Sewer
WaiverNariance request for: NONE Distance:_
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ LN61 CO Waiver Fee $ _
Date of Payment 1 %20!!3 Date of Payment
Receipt Number
COSA# JGC131&0
Receipt Number
Waiver #
S. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm SPURKLAND ENGINEERING
Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501
Engineer's Printed Name LARS SPURKLAND
6. DSD SIGNATURE
System #1 Approved for ^ rT bedrooms
System #2 Approved for bedrooms
Disapproved
Phone 279-3916
Date
Conditional approval for bedrooms, with the following stipulations:
By ' / ` J Original Certificate Date:
The`fvluri ci alitf f Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet r - -
If more than 1 septic system is on the lot:
COSA Checklist # 1 of 1
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: PROSPECT HEIGHTS #2 BLK 7 LOT 6
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID #-
Date completed 9/25/85 Sanitary seal (YM) Y
Total depth 220 ft. Cased to >40 ft.
FROM WELL LOG
Date of test
9/25/85
Static water level
120
ft.
Well production
7
9 -
p.m -WATER SAMPLE RESULTS: 1, 5,
Coliform NEG colonies/100 mL Nitrate X1'92
mg/L
Arsenic ND ug/L Date of sample: 12/11/13
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Parcel ID: 015-134-82
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 18+ in.
AT INSPECTION
6/13/12
70
ft.
4.2
g.p.m.
Collected by: LARS SPURKLAND
Date installed 12/21/87
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y
Date of pumping 6/13/13
C. ABSORPTION FIELD DATA
Depression over tank (Y/N) N High water alarm (YIN) N
Pumper A+ HOME SERVICES
Date installed 10/24/00 Soil rating (g.p.d./ft2 orftz/bdrm) 1'2 System type TRENCH
Length 60 ft. Width 2 ft. Gravel below pipe 7 ft.
Total depth 12 ft. Eff. absorption area 840 ftZ Monitoring tube Y Depression over field N
Date of adequacy test 6/13/12 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth in absorption field before test 46 in. Water added 780 gal. New depth 58 in.
Elapsed Time: 1440 min. Final fluid depth 39 in. Absorption rate >= 750
g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NO If yes, give date
D. LIFTSTATION
Date installed Size in gallons
Pump on" level at in. "Pump off" level at _
Datum
E. SEPARATION DISTANCES
WELL ON LOT TO:
Cycles tested _
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main NA
Sewer /septic service line
251+
Animal containment areas
501+
Manhole/Access (Y/N) _
in. High water alarm level at _
Meets alarm & circuit requirements?_
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout NA
Holding tank NA
Manure/animal excrete storage areas700+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line
51+
Water main NA Water service line 10+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10'+
Water Service line 10+ Surface water 100'+
Curtain drain
501+
Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that l have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name LARS SPURKLAND
Date 12/16/13
COSA brown sheet 10-10-12.doc
Absorption field 5'+
Surface water 100+
Water main 1NA
Driveway, parking/vehicle storage 10'
in.
OF. AC 1lgs j10, rt
4 H ,i
es
E. SPURKLAND%
I NP
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.enchorage.ak.us
907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 01n- )3q- F Z HAA# H /9 0 ,_ 0 /
Expiration Date: _ -7 — / i - O ---7-
1. GENERAL INFORMATION
Complete legal description 1_i to t RV_ 71 -PaoS:)G C 1 yky-A 6+f -i5 ;=k--2,
Location (site address or directions) ID („[szD Sc -4u s! 1brZ.i -9—
Current Property owner(s) 4r.T <.A Day phone A30 = c% J 0 I
Mailing address 190.0 q950-7
Lending agency
Mailing address
Day phone
Real Estate Agent 42 H "th -1 }l_ei4 4, *V e—way_ Day phone
Mailing Address
Y
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:' TYPE OF WASTEWATER DISPOSAL:
Individual Well jg. Individual On-site e'
Individual Water Storage Individual Holding tank
Community Class Well Community On-site
Public Water System Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verity that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm I ob
Address 0203
Engineer's Printed Name
5. DSD SIGNATURE
Approved for _ bedrooms.
Disapproved.
V or, 3
Phone —AN -3910
Date -X)2,010 z
Conditional approval for bedrooms, with the following stipulations:
L
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: r / / Original Certificate Date: "/
tR". 01102)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program *A.
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519650
www.ci.anchorage.sk.us
907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
11 1 z
Legal Description: L Or to B 7 2(LO S p e(, t l -(2 ac Parcel ID: 01 S - J-1 -- 8 2-
A. WELL DATA
Well type If A, B, or C provide PWSID # lam Well Log (Y/N) y
Date completed `'j Sanitary seal (Y/N) Wires property protected (Y/N) y
Total depth ,i2D ft Cased to -7A R Casing height (above ground) l.+ in.
FROM WELL LOG AT INSPECTION
Date of test y S 1.0 5 9 -/ 5 - B4O
Static water level l D'0 R 72 ft
Well production 7 g.p.m. 7 g.p.m.
WATER SAMPLE RESULTS:
Coliform --o—oolonies/100 ml. Nitrate 1, 7 mg./I. Other bacteria 4— colonies/100 ml.
Arsenic: y mg./l. Date of sample:_363/0;L Collected by: S.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material S e D ti e-_ 4'e G Date installed / Z16-7
Tank size J-600 gal. Numtrer of Compartments Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y— Depression over tank (Y/N) 1`4 High water alarm (Y/N) t'-%
Date of pumping A+ Pumper 4/SI v 2_
C. ABSORPTION FIELD DATA
Date installed Io 9i Ofd Soil rating (94mW. or fe/bdrm) System type itdM c
Length _k R Width 2 ft. Gravel below pipe - fL
Total depth _L( R Eff. absorption area 84 0 fe Monitoring tube Depression over field t"4
Date of adequacy test N<.v(/ Results (Pass/Fail) For 5 bedrooms
Fluid depth in absorption field before test in. Water added V"' gal. New depth in.
Elapsed Time: min. Final fluid depth -IL in. Absorption rate >=J A D g.p.d .
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
D. LIFT STATION
Date installed Size in
Pump on' level at _ in. P
Datum cies
E. SEPARATION DISTANCES
Y/N)
otr level at _ in. High water alar level at
tested / Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot l a o
Absorption field on lot 21 a
Public sewer main N/A
Sewer /septic service line 1130
On adjacent lots i /
On adjacent lots >
Public sewer manhole/cleanout tyAl
Holding tank NIA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
T1
Building foundation 5 Property line &0 Absorption field 70
Water main NIA Water service line l t v Surface water N 1 O
Wells on adjacent lots ^> ! D
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line I Building foundation $D Water main Vq/A
Water Service line 9oot) Surface water N I D Driveway, parkinghrehide storage `q O
Curtain drain Nl D Wells on adjacent lots (
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I car* that I have determined through field inspections and
review of Municipal records that the above systerps are in
conformance with MOA HAA guidelines -in effect on this date.
Engineer's Printed Name 101o6err nv21ft.1.Nt
Date 3JOV %D 2
HAA Fee s:375 I -o
Date of Payment y S —o
Receipt Number ] 4
Rev. 12101)
Waiver Fee $
Date of Payment
Receipt Number
AL- ME Environmental Services Inc.
CTBE Ref.# 1021301001
Client Name Tobben Spurkland P.E.
Project Name/# 10600 Shuss Dri
Client Sample ID 10600 Shuss Dri
Matrix Drinking Water
Ordered By
PWSID 0
Sample Remarks:
Client PO#
Printed DateMme
Collected DateMme
Received Date/Time
Technical Dires"t _
Released Bv/l .-....
Pre -Paid COlis/NO3
03/18/2002 16:08
03/13/2002 15:15
03/13/2002 15:50
SteohtaM Ede
Panmaer Results -
Allowable Prep Analysis
PQL Units Method Limits Date Date Init
Waters Department
t
Nitrate -N 1.57 0.200 mg/L EPA 300.0 (<10) 03/13/02 JDT
Microbiology Laboratory
Total Coliform
0
4
0 cot/100mL SM189222B (<I) 03/13/02 SBH
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date 71-/88
1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
a) Legal Description (include lot, block, subdivision, section, township, range)
4_oT G 8C K /3 T /ZAI &3W
Location (address or directions)
FA,¢57' 11MOSE o V S Hu55 To LEST oF1= ppc2 oMALLEI/
ALiIS,Yif loNTivf.TiAL
b) Property Owner
Mailing Address
Home Business
f)[. uD. 03
c) Lending Institution_W01,12,E- S 4Vin GS 6,4,-7/e Telephone
Mailing Address /001 Bc o S In R950F3
d) Real Estate Company and Agent
Address
Telephone
e) Mail the HAA to the following address: or; Check here 0, if hold for pick up. List contact person and day phone number below.
NOm ,E -SA y l &16 s rpt „/,g
1001 i= ae I sp , g 1, a
AkI0__I+QJ2A6g .4?_- 99508
Ar-r,.t: RIcH 3uITTpU
2. TYPE OF RESIDENCE
Single -Family
Number of Bedrooms
3. WATER SUPPLY
Individual Well/ Community Public
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite Public Community Holding Tank
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2
72-025 Mev 81861 Front
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AUTHORITY APPROVAL (HAA)
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1 a 1 1° IECKLIST - FEBRUARY 1984
264-4720
Legal Description: GoT G BLOCK 7
P2DS E"C'T h E/frrrS {`Z
A. WELL DATA
Well Classifi ca ion %'/z) 114 TS If A, B, C, D.E.C. Approved (Y/N) '/ •
Well Log rPesen(Y/ ) / Date Completed /85 Yield
Total Depth 3g0J Z+Cased to yb t SDepth of Grouting NDA/E
Static Water Level y0` /'r
Pump Set At
n
Casing Height Above Ground S5 Sanitary Seal on Casing (Y/N) y
Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) A%
Separation Distances from Well:
To Septic/Holding Tank on Lot /
Z7r ;
On Adjoining Lots i dr f
To Nearest Edge of Absorption Field on Lot On Adjoining Lots /Dd rt
To Nearest Public Sewer Line MILS To Nearest Public Sewer
Cleanout/Manhole MILe$ To Nearest Sewer Service Line on Lot Re>'
Water Sample Collected by Iti%, M`s:rarJJ,&, ; Date __ 71 /Y B
Water Sample Test ResultsS r=FACiote cSee
Comments (AlE_:'LL. Lob NAs fsa7EAf F11'(D
B. SEPTIC/HOLDING TANK DATA
Date Installed Size 15-00 No. of Compartments i-le/O
Standpipes (Y/N) y Air -tight Caps (Y/N) Foundation Cleanout (Y/N) )z
Depression over Tank (Y/N) Al Date Last Pumped NE(.[/ 00nS7.
Pumping/Maintenance Contract on File (Y/N) ; for A6Z4
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Owl
Separation Distances from Septic/Holding Tank:
To Water -Supply Well %Z 7 To Building Foundation /Z r
To Property Line .5-Z1 To Disposal Field
8r
J r
To Water Main/Service Line 1 7 To Stream, Pond, Lake, or Major Drainage
Course-Iyd>A/E /x/'41EA
Comments SEF?r1C f .4 M fL i & STALLED 6 mo, fzGv
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 1Z 5 Type of System Design ln/, IJZA 11U
Date Installed — &1Z01Bg Length of Field 130'
Width of Field
Square Feet of Absorption Area Z
Depression over Field (Y/N) N
Results of Last Adequacy Test /=x,45
Separation Distance from Absorption Field:
To Water -Supply Well 15(
01
To Building Foundation
Lot "0 AJ
7I
Depth of Field
71
Gravel Bed Thickness Z°
Standpipes Present(Y/N) .
Date of Last Adequacy Test AW 71s
To Property Line
On Adjoining Lots
r.
To Existing or Abandoned System on
M
To Water Main/Service Line Ca 6To Cutbank (if present) N o Af E T'112-ESEA17—
To Stream/Pond/Lake/or Major Drainage Course .VoiyE /41' AeEA
To Driveway, Parking Area, or Vehicle Storage Area %o'
Comments ASS6Zp7—toxA F71at_D /A1 STAI—L !o mo AF
D. LIFT STATION
Date Installed _
Size in Gallons
Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
Pump Off' Level at
Check Permitted Bedroom Rating Against HAA Request **
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I have checked vee''fied/, or conformed to all Ofd and HAA guidelines in effect on the date of this inspection. Signed
CompanyA/DmS e:
n7c
rta dQOA No.
Receipt No. ^ OF A1'4%h1aeeBao.Q
Date of Payment — /-rFt `` °
a•`•
Amount: $ _ 120
GLS AndItson 4
Page 2of2
72-026 (11/84)
ro
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LAB INSTRUCTIONS for Work Order # 7887
Date Report Printed: JUL 15 88 6 10:37
Client Sample ID:L6, B7 PROSPECT HEIGHTS
PWSID :UA
Collected JUL 14 88 0 12:30 hrs.
Received JUL 14 88 0 14:30 his.
Preserved with :4 DEG C.
ChemLab Ref. # :1793
j d
Analysis Completed : / — 15 go
Laboratory Supervisor :STEPHEN C. EDE
Released By :
Special HOUSE TAP FROM WELL.
Instruct: HOLD FOR PICK UP AND PAYMENT.
Client Name : MCFADDEN, WAYNE
Client Acct : MCFAWC _
P.O.# NONE REC"D
Req #
Ordered By
Send Reports to:
1)MCFADDEN, WAYNE
2)
Chemlab Client Parameter
Sample # Sample Description Matrix To Test Method Unita Result
1 L6, B7 PROSPECT HEIGHTS 1 20153 -NITRATE -N EPA 353.2 m4/1
